advice: winter is nosebleed season. what can you do about it?
4 minute read
a nosebleed, also known as epistaxis, happens when one of the many small blood vessels in your nose ruptures. getty
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dear asking for a friend,
lately, i’ve been waking every morning with a nosebleed. why is this happening and should i be worried?
signed,
red-nosed and nervous
red-nosed and nervous
dear red-nosed and nervous,
waking up with a stream of blood gushing from your nose is not uncommon, especially in the wintertime when the weather is cold and dry. nosebleeds are rarely serious, but that said, it’s not fun going through box after box of tissues with repeat bloody episodes that can be hard to control.
a nosebleed, also known as epistaxis, happens when one of the many small blood vessels in your nose ruptures, according to the mayo clinic. this can be caused, for example, when something like a fingernail accidentally scratches your nasal tissue while you’re blowing your nose.
it can also simply result from dryness of the nasal tissue which makes the blood vessels more prone to tearing and bleeding. the dry air from indoor heating or outdoor cold in winter is often responsible for winter nosebleeds. there are two types of nosebleeds: the more common “anterior nosebleed,” is when the blood vessels in the front part of the nose rupture. with a “posterior nosebleed,” a larger blood vessel toward the back of the nasal cavity breaks and the blood flows down the back of the throat. the latter tends to be more severe and could require emergency care.
a paper in the journal of otolaryngology, head and neck surgery reports that nosebleeds are an “exceedingly common” problem in hospitals in north america. in fact, they account for about one in 200 er visits in the united states. estimates suggest 60 per cent of people have experienced at least one nosebleed during their life, and only six per cent seek medical treatment. the national center for biotechnology information reports that only 10 per cent of nosebleeds are severe enough to warrant medical intervention.
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sarah messervey, a nurse practitioner in st. john’s, newfoundland and labrador, says there are a few things that can help prevent nosebleeds, and manage them when they happen. she’s seen her share of nosebleeds in children and adults through her acute care and outpatient work at the city’s janeway children’s hospital, and the health sciences centre where she specialized in the treatment of bleeding disorders. last march, she moved to her new nursing role in the medical unit of her majesty’s penitentiary in st. john’s where inmates can have nosebleeds from nasal drug use, for example, along with dry air.
just like you get dry lips, your nose dries out as well
“we live in canada, our winters are cold, so we see a big uptick in nosebleeds during the winter months, and that tends to be expected,” she says. “when you’re blasting your electric heat, it’s drying out those mucus membranes, just as you get dry lips, your nose dries out as well when you’re sleeping at night. you can often wake up with a nose bleed.”
messervey says using a humidifier at night in your bedroom can help combat dryness and supply much-needed moisture to the nasal tissue. also, be gentle with your nose, because picking, frequent vigorous blowing or rubbing can irritate those fragile blood vessels, provoking a nosebleed.
when one strikes, lean slightly forward to avoid bleeding into your throat, breathe through your mouth and pinch your nostrils shut.
“you have to apply some pretty significant pressure,” she advises, using your fingers or specialty nose clips from the drugstore. “compression is important with firm pressure for at least 10 to 15 minutes without interruption.” then take a short break and repeat — some nosebleeds can last for 30 minutes or more.
once the bleeding has stopped, messervey recommends using an over-the-counter nasal gel or spray like rhinaris or secaris which are water-based lubricants to add additional moisture.
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when to worry about a nosebleed
“if a nosebleed lasts under an hour, i wouldn’t be too concerned,” she says. “but if it lasts longer than an hour and it’s quite profuse and you’ve tried those conservative measures like pinching off and applying pressure, i would be going straight to urgent care or emergency, because you want a place with the capabilities to be able to treat it.”
messervey cautions that there may be underlying reasons for nosebleeds — they tend to be more common in people taking antihistamines or decongestants for allergies or chronic sinus issues that dry out the nose. also at risk for nosebleeds include those on anticoagulant medicines for heart disease, high blood pressure or other vascular disorders, since these blood-thinning drugs change the blood’s ability to clot and can provoke a nosebleed or make one harder to stop. people with a bleeding disorder may be at higher risk as well.
another cause could be a deviated septum, a structural problem with the septum or wall in the middle of your nose. sinus tumours are possible, although rare, and spider veins can happen in your nose that can be a source of bleeding.
“no one knows what the inside of their nose really looks like,” she says, adding a professional exam is always a good idea if you have an ongoing health problem. “if it’s dry and you’re getting a nose bleed intermittently here and there, that’s not such a cause for concern. but if you’re waking up every day [with one] and they’re out of nowhere, see your family doctor. sometimes it’s just a prominent blood vessel that bleeds significantly and you can go and have it cauterized and never have a nose bleed again.”
karen hawthorne is a toronto-based writer.
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